| NPI | 1821179490 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 101YM0800X Counselor, Mental Health (Licence: NY 004494) |
| Additional Taxonomies | 101YP2500X Counselor, Professional (Licence: PA PC001093) |
| 1041C0700X Social Worker, Clinical (Licence: MA 204358) | |
| Enumeration Date | 2006-10-18 |
| Last Update Date | 2010-07-29 |